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December 2022
OHCA is expanding coverage for SoonerCare members receiving pregnancy and postpartum services. Two major policy changes will help ensure that more women have access to better, longer health care.
The first change is to increase Oklahoma’s income threshold for full-scope pregnancy-related benefits from 138% to 205% of the federal poverty level (FPL).
Secondly, OHCA will be providing eligible, new mothers with up to 12 months of continuous postpartum coverage. SoonerCare currently provides full-scope pregnancy benefits, including 60 days of postpartum coverage for women with incomes up to 138% of the FPL.
Both of these policy changes go into effect on Jan. 1, 2023.
The flu season has arrived and is hitting hard. Flu hospitalizations are higher than they have been in the past 10 years, and the Oklahoma State Department of Health is urging people to get their annual flu shot.
Flu vaccines are available to SoonerCare members 18 years of age and younger through a federal Vaccines for Children (VFC) program provider, usually your child's pediatrician or primary medical provider. Members 19 years of age and older can receive the vaccine through both the SoonerCare prescription drug benefit and the medical benefit. Flu vaccines administered by pharmacies do not count against a member’s monthly prescription limit, and there is no copay for members.
Another virus to be aware of is respiratory syncytial virus (RSV). If you have cold-like symptoms of runny nose, sore throat, cough, congestion, headache, tiredness or fever, you may have RSV.
RSV is a contagious virus that is usually mild, but it can severely affect the lungs and respiratory airways in older adults ages 65 and older. Those at highest risk for severe RSV infection are people with chronic heart or lung disease, and adults with weakened immune systems.
RSV also commonly affects young children less than 2 years of age. It is the number one cause of pneumonia and lower respiratory infections in children under the age of 1.
The Oklahoma State Department of Health has indicated that RSV cases are on the rise in the state. Similar to some other respiratory infections, a cough or sneeze can easily spread RSV. There is no vaccine or treatment for RSV, but learning how to prevent exposure can help protect you and your loved ones.
Are you looking to quit smoking or vaping in the new year? Schedule a visit to your provider for options to help you stop – FOR GOOD. For example, many Nicotine Replacement Therapies, or NRT, can be combined to eliminate cravings. SoonerCare has no prescription limit on most NRTs available and NRT is not considered in the monthly prescription limit. Plus, its FREE for SoonerCare members! Start the New Year out right with help to quit! For more information, visit the Oklahoma Tobacco Helpline at www.okhelpline.com.
More Americans die from lung cancer than any other type of cancer. Lung cancer is the second most common cancer worldwide. Often, lung cancer is not detected in time for life-saving treatments because many individuals have no symptoms until the cancer has reached an advanced stage. For this reason, yearly lung cancer screenings are recommended to those who have a history of smoking or have quit within the past 15 years.
Are you between the age of 50 and 80? If so, you may be eligible for an annual low-dose CT lung cancer screening test. See below for some of the qualifiers for this benefit:
- If you are between the ages of 50-80
- If you have smoked 20 or more cigarettes per day for 20 or more years (currently not available for cigar and vape users)
- If you have you quit smoking cigarettes within the last 15 years
If you can answer yes to any of the above, talk with your health care provider about the benefit of lung cancer screening which has been shown to reduce the risk of death from lung cancer by 20% — not to mention the peace of mind!
For more information, reach out to the SoonerQuit program at SoonerQuit@okhca.org.
While SoonerCare does not cover these items, they are available to eligible members through another program. If you're in need of a baby crib, call Infant Crisis at 405-528-3663. For breast pumps, check the local WIC office at WICHealth.org. If you need additional help, contact the SoonerCare helpline at 877-987-7767.
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At the beginning of the COVID-19 pandemic, the federal government declared a public health emergency (PHE). During the PHE, we are required to continue SoonerCare coverage for all members even though there are some members who no longer qualify for benefits.
Example of reasons why a member may no longer qualify for benefits:
- Your salary is now higher than the required amount to receive SoonerCare benefits.
- Someone has moved in or out of your household.
- Your contact information and/or documents are not updated at MySoonerCare.org.
There will come a time when the PHE will end. Once we know the day, we will send notifications to those people who no longer will receive SoonerCare benefits. Those members determined to be ineligible for benefits will be removed from SoonerCare in phases focusing on the member’s benefit utilization and critical health issues.
Members should take time to think about their health care needs and plan in case their SoonerCare coverage ends. Please go to MySoonerCare.org to learn more.
If you have documents to submit to SoonerCare, the fastest way to send them is by uploading online through the SoonerCare member portal. Uploading will get your documents processed faster over mailing them in.
For SoonerCare to fulfill your request, please make sure spam blocking is turned off on your phone. Sometimes when we return a call, it can show up as spam. Our phone number may also come up as a Colorado or Florida number on your caller ID.
About OHCA
Please call the SoonerCare helpline at 800-987-7767 if you have questions about your coverage or benefits. For updates on new policies, health tips, helpful resources and more, follow OHCA on Facebook and/or Twitter. The Oklahoma Health Care Authority does not discriminate on the basis of race, color, national origin, sex, religion, age or disability in employment or the provision of services.
 
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